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[Studies on maternal hemodynamics during normal pregnancy: correlation between maternal hemodynamics and fetal growth].

The cardiac output (CO) and cardiac index (CI) were examined by echocardiography throughout pregnancy and 1 month of puerperium and the results were compared with fetal growth as determined by birth weight. The results are as follows. The changes in CO and CI during the pregnancy and puerperium of normal pregnant women (n = 48) were similar in all subjects, and reached the maximum at the 24th-31st week's of gestation. On the 5th day of puerperium, the CO and CI values were almost the same as those obtained at the 32nd-40th weeks of gestation, and after 1 month of puerperium the values were same as those obtained in the non-pregnant period. The CO and CI of HFD child-bearing group (n = 8), AFD child-bearing group (n = 30) and LFD child-bearing group (n = 10) were compared. The CO and CI values for the LFD group were lower than those for AFD group; particularly, significant differences (p less than 0.05) were observed in 24th-31st weeks and 32nd-40th weeks of gestation. The CO and CI values of HFD group tend to be higher than those for AFD group, but there is no statistical significance between the two groups. The birth weight correlated to the rate of increase in CO and CI during pregnancy with coefficients of correlation of 0.56 (p less than 0.05) and 0.54 (p less than 0.05), respectively. The rate indicates the ratio of maximum values of CO and CI obtained during pregnancy to the values after 1 month of puerperium, which have been shown to be consistent with those during the non-pregnant period. A significant correlation (r = 0.54, p less than 0.05) was found between placenta weight and birth weight. The correlations between placental weight and the rate of increase in CO and CI were also significant with coefficients of correlation of 0.40 (p less than 0.05), and 0.38 (p less than 0.05), respectively.

Birth Weight↗

[Positive serology for syphilis in neonatal period: prevalence in secondary level maternity. Association with maternal risk factors and with positive serology for HIV-1].

To study neonatal Syphilis seropositivity incidence, its association with HIV-1 seropositivity and the impact of Congenital Syphilis CDC case definition, cord blood VDRL and Indirect Hemagglutination (IHA) for Syphilis were performed in 3,664 newborns from Dec/91-July/92. A positive group was formed by those with positive VDRL and IHA or just positive IHA. The control group consisted of 200 VDRL and IHA negative neonates. Among the 3,664 neonates 5.6% were seropositive for Syphilis. A significant association was noted (p < or = 0.05) between neonatal seropositivity for Syphilis and mothers older than 20 years, single, with sexual promiscuity, drug use, no pre-natal care, multiparity and previous still-births. All positive neonates fitted in the Presumptive Congenital Syphilis CDC definition. In 50 seropositive for Syphilis neonates ELISA for HIV-1 was performed and 6/50 were positive. Congenital Syphilis is of concern, specially in neonates of mothers with risk factors for Syphilis acquisition. HIV-1 should be considered in seropositive for Syphilis neonates. Adoption of Congenital Syphilis new CDC case definition is advised, particularly in countries where prenatal care is deficient.

AIDS Serodiagnosis↗

[Hemolytic disease in a newborn infant caused by rare maternal anti-erythrocyte antibodies and exchange transfusion with maternal blood frozen earlier].

After a pregnancy of 31 weeks and 4 days a pale baby girl was born with mild oedema, severe anaemia (4.2 mmol/l), increased normoblast count and hyperbilirubinaemia, indicating a blood group antagonism. This was caused by very rare irregular antibodies with the specificity anti-U. These antibodies had been demonstrated in the mother before, after earlier transfusions with erythrocytes. At that time autologous blood was stored at -70 degrees C in the Central Laboratory of the Dutch Red Cross in Amsterdam, because U negative donors are hard to find. One of these units was used for an exchange transfusion given to the baby, who recovered well. This case study underlines the necessity of screening for presence of irregular antibodies during pregnancy. A national registration of patients with antibodies against erythrocytes is recommended.

ABO Blood-Group System↗